ABSTRACT (modified form Parent Proposal) Alzheimer's disease (AD) is a major public health threat. Along with better diagnostic tools and treatments, a pressing need exists for more information on AD in diverse populations. The AD Centers Program is a landmark effort to develop solutions sponsored by the National Institute on Aging. The University of Washington AD Research Center will contribute to this Program through our vision of precision medicine for AD, namely, comprehensive classification of an individual's risk; early detection of pathophysiologic processes, especially while manifestations are preclinical; and interventions tailored to an individual's molecular drivers of disease. Our Cores and Projects are focused on this vision, as well as our 5-year mission to create the requisite knowledge and tools to advance research on preclinical biomarkers and experimental therapeutics. We will collaborate on a wide range of topics pertinent to AD such as clinical trials, genetics, brain aging, diagnostics, and outreach to disparities populations. The AD Research Center balances stability with innovation. Stability in the leadership of the Cores assures that we will achieve the best outcomes. Innovation draws on the vast resources of the University and our partners to develop 3 new Projects, a new Satellite Core, and a new component of our Clinical Core to fuel discoveries. The Satellite Core is recruiting 100 American Indians from the Southern Plains (Oklahoma) who participated in the Strong Heart Stroke Study, an enormous effort that administered cognitive tests and MRIs in 1,033 American Indians from 12 communities in 3 states. Our Specific Aims are to 1) Enlarge the sample size of the Satellite Core by initiating recruitment in 2 other field sites that participated in the Strong Heart Stroke Study: the Southwest and Southern Plains field sites; 2) Use the same cognitive function and structural MRI protocols to re-examine participants and document changes over time; 3) Collaborate with the Clinical Core to assign cognitive diagnoses and collect samples for future research; 4) Work with the Outreach, Recruitment, and Education Core to raise awareness of AD and provide education to AIs; and 5) Enhance the overall University of Washington AD Research Center and AD Centers Program by pursuing an unparalleled opportunity to advance AD research with a dramatically understudied and underserved population. These efforts resonate strongly with the principles of National Plan to Address Alzheimer's Disease to ?transform the way we approach AD? and the equally important goal of increasing the diversity and representativeness of populations in the AD Centers Program. Successful completion of our Center's 5-year mission will hasten the transformation to offer the right intervention for the right person (including American Indians) at the right time.